Burns : journal of the International Society for Burn Injuries
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This study aimed to investigate whether previous findings from a small retrospective study could be replicated prospectively. The previous study showed that patients with an existing diagnosis of psychosis or depression, admitted to a burns service, had longer hospital stays and longer wound healing times when compared with controls matched for burn injury but without a pre-existing psychiatric condition [1]. In this study it was hypothesised that those patients without pre-existing psychiatric diagnosis, but with high levels of psychological distress after burn would also show a similar pattern of delayed recovery to those with a pre-existing psychiatric illness. ⋯ An exploratory model entering all the variables stepwise at the same stage identified poor adherence and delayed discharge issues as making significant contributions to the final model (r=0.81 adjusted r(2)=62.9, F (4, 42)=20.48, p<0.001). In conclusion, this study supports the role of psychosocial factors, such as pre-existing psychiatric diagnosis and in hospital psychological distress, in contributing the recovery of survivors of burns. This suggests that identifying and working with these difficulties may impact not only on psychosocial, but also physical aspects of recovery.
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Hypertrophic scars on trunk and thigh are less important in function and appearance than those on face, neck, hand, foot and joint. However, patients suffer itching, pain and disfiguration. Thus far, neither non-surgical nor surgical methods treat these scars perfectly. This study reports on the application of liposuction technique to reconstruct these scars and reviews the outcomes. ⋯ Large hypertrophic scar at sites rich in subcutaneous fat such as trunk and thigh can be reconstructed in one stage by liposuction technique, which is easy, safe, effective and economic. Although indications of liposuction scar reconstruction are strict, it is indeed a better option for appropriate cases.
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The aim of this study was to apply the RIFLE [risk (R), injury (I), failure (F), loss (L) and end-stage kidney disease (E)] criteria in burn ICU patients, to identify the risk factors for occurrence of acute kidney injury (AKI), as well as to analyze the progression between stages (classes) of RIFLE classification, and the impact of progression of AKI on morbidity and mortality. ⋯ This study demonstrated (a) the high incidence of AKI in patients with severe burns; (b) the number of predisposing to progression of AKI factors (severity of organ failure, presence of sepsis, use of nephrotoxic drugs, number of previous surgical operations, cumulative fluid balance); (c) the association of Failure class of acute kidney injury with high mortality.